Social determinants in hemodialysis patients: a view from hermeneutical phenomenology

Abstract

Chronic Kidney Disease is the gradual loss of kidney function whose treatment is hemodialysis, where social conditions affect the patient’s health. The purpose of the study is to generate a theoretical corpus on the meaning of social determinants in hemodialysis patients in the therapy units of Punto Fijo, Falcón state. Theoretically, the elements related to the epistemology of chronic kidney disease and the social determinants of health are presented. The methodological support is based on the interpretive paradigm with a qualitative approach under the methodological tradition in Hermeneutic Phenomenology. The key informants were five hemodialysis patients from the different health centers in the study context. The data collection instruments were observation and interview, and for the analysis we worked with the spin and the hermeneutic matrix. Among the findings found are: awareness of care, support among colleagues, professionalism of the staff, conditions of the hemodialysis centers, provision of medications, family nucleus as support for the patient, belief in God as spiritual support, initial acceptance of the condition renal, conditions for transplant in the hemodialysis patient, patient resilience. The theoretical corpus generated is called Exegesis of the experiences lived by hemodialysis patients, which consists of four principles: Transformation of habits of hemodialysis patients adapted to the living condition, Affective-spiritual requirement, Adaptability of the hemodialysis patient to the system health and resilient attitude of the hemodialysis patient.